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Anesthesiolgy > Pre-Medication Drugs > Flashcards

Pre-Medication Drugs Flashcards

1
Q

Define sedation

A

induction of CNS depression and drowsiness by the use of drugs

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2
Q

Define dissociative anesthesia

A

a form of general anesthesia characterized by a catatonic state
- neural information is processed without proper coordination in space and time

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3
Q

What is neuroleptanalgesia?

A

a state similar to general anesthesia produced by a sedative and analgesic agent

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4
Q

What are the actions of anticholinergics?

A
  • inhibit the parasympathetic nervous system

- antagonists on muscarinic Ach receptors

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5
Q

Atropine

type, solubilty, admin, barriers

A
  • anticholinergic
  • lipid soluble
  • absorbs well IM, SC, PO
  • crosses BBB and placental barrier
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6
Q

Glycopyrrolate

type, solubilty, admin, barriers

A
  • anticholinergic
  • water soluble
  • absorbs slowly IM, SC, PO
  • doesn’t cross BBB or placental barrier
  • onset of effect slower than atropine
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7
Q

What are the indications for anticholinergics?

A
  • increasing heart rate (opioid induced bradycardia, reflex bradycardia)
  • decreasing salivation and bronchial secretion
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8
Q

What are the contraindications for anticholinergics?

A
  • tachycardia
  • hyperthyroidism
  • most heart diseases
  • narrow angle glaucoma
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9
Q

What are the effects of alpha-2 agonists on pre-synaptic membranes?

A
  • sedation
  • analgesia
  • reduction of sympathetic outflow from brain
  • reduction of stress response (decreases NE and EP blood levels)
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10
Q

Where are the post-synaptic membrane alpha-2 receptors located, and what are their effects?

A
  • wall of arteries and veins

- mediate vasoconstriction

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11
Q

Where are the extra-synaptic sites of alpha-2 receptors, and what are the effects?

A
  • adipocytes: inhibition of lipolysis

- pancreatic B-cells: inhibition of insulin release

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12
Q

What are the CV effects of alpha-2 agonists?

A
  • strong vasoconstriction
  • reflex bradycardia
  • low CO and tissue perfusion
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13
Q

What are the respiratory effects of alpha-2 agonists?

A
  • mild respiratory depression
  • decreased RR, increased tidal volume
  • upper airway resistance
  • V/Q mismatch in horses
  • bronchoconstriction, lung edema, hypoexemia, and V/Q mismatch in ruminants
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14
Q

What are the GI effects of alpha-2 agonists?

A
  • decreased salivation
  • LES tone decreases
  • decreased GI motility
  • vomiting
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15
Q

What are the indications for alpha-2 agonists?

A
  • sedation of aggressive animals
  • sedation to prevent post-op airway obstruction
  • prevention/treatment of seizures
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16
Q

What are the contraindications of alpha-2 agonists?

A
  • too young or too old
  • hemodynamic instability
  • severely debilitated
  • risk patients
17
Q

Name 5 alpha-2 agonists

A 
Xylazine
Dexmedetomidine
Medetomidine
Detomidine
Romifidine
18
Q

Name 3 alpha-2 antagonists

A

Atipamezole
Yohimbine
Tolazoline

19
Q

Which receptors do phenothiazines atagonize?

A
  • dopamine
  • serotonin
  • alpha-1
  • histamine
20
Q

What are the CNS effects of Acepromazine?

A
  • antagonizes dopamine and serotonin
  • weaker sedative than alpha-2 agonists
  • no analgesic
  • antiemetic
  • mild respiratory depression
21
Q

What are the CV effects of Acepromazine?

A
  • antagonist on alpha-1 receptors

- vasodilation and hypotension

22
Q

What are the indications for phenothiazines?

A
  • mild sedation
  • prevention/treatment of opioid dysphoria
  • prevention of emesis caused by morphine
  • sedation for dogs with laryngeal paralysis
  • enhance sedative effect of xylazine in horses
23
Q

What are the contraindications for phenothiazines?

A
  • hyovolemia, hemodynamic instability

- Von-Willebrand disease

24
Q

What are Benzodiazepines, and what are their main effects?

A
  • GABA agonists
  • sedative, anticonvulsant, muscle relaxant
  • minimal CV and respiratory effects
  • no analgesia
25
Q

What drugs can you combine with benzodiazepines for premedication?

A
  • opioids
  • alpha 2 agonists
  • both
26
Q

What drugs can you combine with benzodiazepines for induction?

A
  • dissociative agents (ketamine)

- barbiturates or propofol

27
Q

Diazepam

solubility, admin, metabolization, chem compatibility

A
  • lipid soluble
  • give slowly IV
  • poor absorption and pain on IM injection
  • metabolized in liver, active metabolites
  • limited chemical compatibility
28
Q

Midazolam

solubility, admin, metabolization, chem compatibility, compared to diazepam

A
  • water soluble
  • given IM, IV or via mm
  • metabolized in liver, inactive metabolites
  • good chemical compatibility
  • more potent, shorter acting than diazepam
29
Q

What are the effects of opioids?

A
  • minimal CV effects
  • analgesia (best for acute pain)
  • decreases MAC of inhalants
  • sedation
  • inhibit or trigger vomiting
  • may depress respiratory
30
Q

How can opioids be given for premedication?

A

alone or in combination with:

  • benzodiazepines
  • benzodiazepines and ketamine
  • acepromazine
  • alpha 2 agonists
31
Q

Morphine

effects, onset/duration, metabolism

A
  • strong analgesic
  • slow onset, long duration
  • metabolized in liver, active metabolite
  • may cause histamine release after high IV doses
32
Q

Hydromorphone

effects, duration

A
  • strong analgesic (full μ agonist)
  • duration 4 hours
  • no histamine release
33
Q

Fentanyl

effects, onset/duration

A
  • strong analgesic (full μ agonist)
  • fast onset, short duration
  • no histamine release
  • may accumulate after long infusions
34
Q

Butorphanol

type, effects

A
  • antagonist on μ and agonist on κ

- weak and short acting analgesic

35
Q

Buprenorphine

type, onset/duration

A
  • partial μ agonist

- slow onset, long duration

36
Q

Tramadol effects

A
  • weak analgesic

- inhibits NE and serotonin reuptake

37
Q

Guaifensesin

type of drug, effects

A
  • centrally acting muscle relaxant
  • minimal CV and resp effects
  • no analgesia or unconsciousness
38
Q

What are the CV side effects of anticholinergics?

A
  • initially: AV block, bradycardia, cardiac arrest
  • tachycardia
  • hypertension

Anesthesiolgy (10 decks)

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